Long-term outcome of pre-specified ECG patterns in acute coronary syndrome.

Autor: Koivula K; Faculty of Medicine and Health Technology, Tampere University, Finland; South Karelia Central Hospital, Finland. Electronic address: kimmo.km.koivula@gmail.com., Konttila KK; Faculty of Medicine and Health Technology, Tampere University, Finland., Eskola MJ; Heart Center, Department of Cardiology, Tampere University Hospital, Finland., Martiskainen M; Fimlab Laboratories Tampere University Hospital, Tampere, Finland., Huhtala H; Faculty of Social Sciences, University of Tampere, Finland., Virtanen VK; Heart Center, Department of Cardiology, Tampere University Hospital, Finland., Mikkelsson J; Heart Center, Satakunta Central Hospital, Pori, Finland., Järvelä K; Heart Center, Tampere University Hospital, Finland., Niemelä KO; Heart Center, Department of Cardiology, Tampere University Hospital, Finland., Karhunen PJ; Faculty of Medicine and Health Technology, Tampere University, Finland; Fimlab Laboratories Tampere University Hospital, Tampere, Finland., Nikus KC; Faculty of Medicine and Health Technology, Tampere University, Finland; Heart Center, Department of Cardiology, Tampere University Hospital, Finland.
Jazyk: angličtina
Zdroj: Journal of electrocardiology [J Electrocardiol] 2020 Sep - Oct; Vol. 62, pp. 178-183. Date of Electronic Publication: 2020 Aug 08.
DOI: 10.1016/j.jelectrocard.2020.08.001
Abstrakt: Background: Long-term outcome of real-life acute coronary syndrome (ACS) patients with selected ECG patterns is not well known.
Purpose: To survey the 10-year outcome of pre-specified ECG patterns in ACS patients admitted to a university hospital.
Methods: A total of 1184 consecutive acute coronary syndrome patients in 2002-2003 were included and followed up for 10 years. The patients were classified into nine pre-specified ECG categories: 1) ST elevation; 2) pathological Q waves without ST elevation; 3) left bundle branch block (LBBB); 4) right bundle branch block (RBBB) 5) left ventricular hypertrophy (LVH) without ST elevation except in leads aVR and/or V 1 ; 6) global ischemia ECG (ST depression ≥0.5 mm in 6 leads, maximally in leads V 4-5 with inverted T waves and ST elevation ≥0.5 mm in lead aVR); 7) other ST depression and/or T wave inversion; 8) other findings and 9) normal ECG.
Results: Any abnormality in the ECG, especially Q waves, LBBB, LVH and global ischemia, had negative effect on outcome. In age- and gender adjusted Cox regression analysis, pathological Q waves (HR 2.28, 95%CI 1.20-4.32, p = .012), LBBB (HR 3.25, 95%CI 1.65-6.40, p = .001), LVH (HR 2.53, 95%CI 1.29-4.97, p = .007), global ischemia (HR 2.22, 95%CI 1.14-4.31, p = .019) and the combined group of other findings (HR 3.01, 95%CI 1.56-6.09, p = .001) were independently associated with worse outcome.
Conclusions: During long-term follow-up of ACS patients, LBBB, ECG-LVH, global ischemia, and Q waves were associated with worse outcome than a normal ECG, RBBB, ST elevation or ST depression with or without associated T-wave inversion. LBBB was associated with the highest mortality rates.
Competing Interests: Declaration of Competing Interest None.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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